Postprandial Blood Sugar Research Articles

Nutritional, Biochemical, and Functional Properties of Spinach Leaf-Enriched Dough: A Healthier Alternative to Conventional Pasta

This study explored the effects of spinach flour (SF) enrichment on pasta, focusing on chemical, nutritional and sensory properties, cooking performance, and microbiological stability. SF was added at 12.5% (PSP12) and 25% (PSP25). The enriched pasta had a lower pH than the control (CP), due to spinach-derived organic acids, with PSP25 showing the highest fiber content. Enrichment increased B vitamins and minerals, especially calcium, magnesium, sodium, and potassium. PSP25 had a shorter cooking time, higher water absorption, and greater cooking loss. Enriched pasta showed lower starch hydrolysis index and predicted glycemic index, suggesting potential benefits for managing postprandial blood sugar levels. SF significantly altered the free amino acid (FAA) profile, with PSP25 showing the highest concentration of total FAAs. Antioxidant assays demonstrated that spinach-enriched pasta retained higher levels of phenols and flavonoids, after cooking also, compared to CP. Sensory analysis indicated that while PSP12 had higher overall acceptability, PSP25 exhibited stronger herbaceous flavors, which could affect consumer preference. Microbiologically, all samples were stable for 110 days. The findings suggest that SF enrichment enhances the nutritional value, antioxidant potential, and sensory qualities of pasta, with potential for commercial applications, although consumer acceptance could be influenced by its non-traditional taste and texture.

Effects of thyroid status on HbA1c

Introduction: Altered erythrocyte turnover may not adequately reflect the glycemic status in the glycated hemoglobin (HbA1c) levels. Hypothyroidism is one such condition that might cause reduced erythropoiesis and falsely high HbA1c values. The aim of the study is to evaluate the effect of thyroid hormone on HbA1c levels on non-diabetic hypothyroid individuals and also to evaluate HbA1c levels in hypothyroid individuals with diabetes and to compare them with normal healthy subjects. Methods: This prospective study was conducted on 210 individuals, of whom 70 were assigned to group I- hypothyroid individuals, 70 to group II- hypothyroid individuals with diabetes, and 70 to group III—Normal individuals. Following data regarding laboratory investigations were collected which included fasting blood sugar (FBS), postprandial blood sugar (PPBS), HbA1c, free triiodothyronine (fT3), free thyroxine (fT4), and thyroid stimulating hormone (TSH). Data analysis was performed using SPSS version 16.0. Results: The median level of HbA1c was significantly higher in hypothyroid than in normal individuals (5.6 [5.5-5.7] % vs 5.2 [5-5.3] %, P≤0.001). The median level of TSH was significantly higher in hypothyroid than in normal individuals (11.13 [6.9-22.9] μIU/mL vs 2.15 (1.33-1.60) μIU/mL). The serum level of HbA1c was significantly positively correlated with TSH in hypothyroid individuals (r=0.281, P≤0.01). Conclusion: There is a positive correlation between HbA1c and TSH, and a negative correlation between HbA1c and fT4 levels. Serum HbA1c levels were significantly higher in hypothyroid individuals than the normal individuals. Therefore, our study suggests that we should proceed with caution while interpreting HbA1c levels in individuals with hypothyroidism.

Diagnostic accuracy of DIPSI criteria for diagnosing gestational diabetes mellitus in Puducherry

ABSTRACT Context: Gestational diabetes mellitus (GDM) is a major concern in recent years. During pregnancy, it is difficult to consume 75 g of glucose in the fasting state as pregnant women may experience symptoms such as vomiting. The Diabetes in Pregnancy Study Group India (DIPSI) criterion requires a single prick in the non-fasting state to collect the sample for diagnosing GDM. Aims: This study aimed to assess the diagnostic accuracy of DIPSI criteria compared to the WHO criteria for GDM diagnosis. Settings and Design: A community-based cross-sectional study was conducted among pregnant mothers attending the primary health centers in Puducherry from August 2022 to November 2022. Methods and Material: A total of 384 samples were selected, and 75 g of anhydrous glucose was given after 8 hours of overnight fasting. Both fasting and postprandial venous blood sugar levels were measured to determine the prevalence of GDM as per the WHO 2013 criteria. After 2 days, GDM was diagnosed among all study participants based on the DIPSI criteria. Further analysis was done. Results: The prevalence of GDM was 14.1% and 12.8% per the WHO 2013 and DIPSI criteria, respectively. In comparison to the WHO 2013 criteria, DIPSI had 79.63% sensitivity, 98.18% specificity, 87.76% positive predictive value, and 96.72% negative predictive value. The results of kappa statistics showed that there was almost perfect agreement between the WHO 2013 criteria and DIPSI criteria. Conclusions: The present study shows that the DIPSI criteria can be used to screen and diagnose GDM as there is no need for overnight fasting. The blood glucose value can be measured easily with a single prick, which is comfortable for both pregnant women and treating doctors.

A Comparative Study on the Impact of Fasting on Blood Glucose and Blood Pressure Among Diabetic and Non-Diabetic Individuals During Ramadan, Kurdistan Region, Iraq

Objective: The primary aim of this research was to evaluate the differential effects of regular and fasting dietary patterns on blood glucose levels and blood pressure among diabetic patients and non-diabetic control group. A comprehensive analysis was conducted to compare physiological responses on fasting versus non-fasting days during the holy Ramadan month. Methods: This observational study involved 92 participants, with a subset of 38 diabetic patients and 54 non-diabetic control group, aged 19-76 years, who were observed on regular and fasting days. Participants were monitored for pre-prandial, postprandial, evening blood sugar, and fasting blood glucose levels, as well as blood pressure. Statistical analysis was performed using paired sample t-tests to compare mean ± SD between regular and fasting days of both groups. The study cohort consisted of male and female adults diagnosed with type 1 or type 2 diabetes. Exclusion criteria included individuals under 18 years, pregnant women, and patients unable to fast during the study period. Results: Statistical analysis revealed significant differences in fasting blood glucose levels during Ramadan compared to non-fasting days. In the diabetic group, significant changes were observed in fasting blood glucose levels during Ramadan compared to after Ramadan ( postprandial blood sugar p=0.04, evening blood sugar p=0.019). In contrast, the non-diabetic group also showed significant changes in blood glucose levels during Ramadan compared to after Ramadan (postprandial blood sugar p=0.001, evening blood sugar p=0.020). Blood pressure showed no significant differences between these periods, suggesting that fasting does not alter blood pressure significantly in diabetic individuals. Additionally, a two-way ANOVA demonstrated significant dietary influences on post-Iftar glucose levels in non-diabetics (p<0.001), but not in diabetics, suggesting differential metabolic responses to dietary intake during Ramadan. These findings emphasize the critical need for personalized dietary management and continuous monitoring to optimize diabetic care during fasting. Conclusion: Fasting significantly influences blood glucose levels in diabeticand non-diabetic individuals but does not affect blood pressure. This study underscores the necessity for personalized medical guidance and balanced meal planning to minimize complications and enhance diabetes management during fasting. Further research is warranted to explore the long-term effects of different fasting practices on diabetic health outcomes.

Association of serum bilirubin levels and glycemic measurements in Type 2 diabetic patients

Introduction: Bilirubin, a waste product of the heme catabolic pathway, has proven to be a natural antioxidant associated with a lower prevalence of oxidative stress-mediated diseases. This study evaluates the association of serum bilirubin levels with Glycated Hemoglobin (HbA1c), Fasting Blood Sugar (FBS) and Post Prandial Blood Sugar (PPBS) in diabetic patients. Methods: A retrospective analytical study was conducted at the Department of Haematology of the Sri Jayewardenepura General Hospital. Data was obtained through a laboratory information system of randomly selected 201 adult patients diagnosed with T2DM and grouped as poorly and well controlled using HbA1c values over and below 7%, respectively. Normal ranges for serum bilirubin, FBS, and PPBS were (0.3-1.2) mg/dL, (75-110) mg/dL and (80-140) mg/dL, respectively. Data were analyzed using (SPSS) version 20, descriptive statistical methods, Pearson’s Correlation test and independent sample t-test. P<0.05 was considered significant. Results: A negative correlation between total bilirubin and HbA1c (r = -0.234, p=0.001) was observed. There was no statistically significant correlation between total bilirubin level and FBS (p=0.131), PPBS (p=0.408), and age (p=0147). However, the mean values of total bilirubin (p=0.001), FBS (p<0.001) and PPBS (p<0.001) were significant between diabetes well controlled and poorly controlled groups. A statistically positive correlation was observed between HbA1c and FBS (p<0.001) and PPBS (p<0.001), but not with age (p=0.887). Conclusion: There was a significant relationship between total bilirubin with FBS, and PPBS in both groups. A significant negative correlation was found between total bilirubin and HbA1c, suggesting a potential protective or modulatory role of bilirubin in glycemic control. No significant correlation was observed between total bilirubin levels and FBS, PPBS, or age in the total population.Keywords: T2DM, HbA1c, bilirubin, FBS, PPBS

Treatment of Early Gestational Glucose Intolerance

Aim: This study aims to find out the risk of gestational diabetes mellitus (GDM) in the first trimester at 8 weeks based on the 2-hour postprandial blood glucose (2hr PPBG) levels. It also aims to assess the risk of GDM with intervention using Metformin. Methodology: This study was carried out in two centres with 182 pregnant women in Group A, 100 in Group B, and 69 in Group C. The participants were screened at 8-10 weeks, and DIPSI tests were performed to check for GDM development. Results: In Group A, when the 2hr PPBG was less than 110 mg/dl, only 4% and 1.2% of participants developed GDM in Study 1 and Study 2, respectively. For Group B, 95.9% of the participants developed GDM with 2-hour postprandial blood sugar of ≥110 mg/dl and no intervention. However, in Group C with intervention using Metformin, only 1.4% of the women developed GDM. Key Words: EGGI; GDM; PPBG; DIPSI Diabetes mellitus is a rapidly evolving pandemic and a significant public health problem in recent decades [1]. It affects millions of people worldwide, significantly impacting the quality of their lives. Efforts are underway globally to detect diabetes in its early stages and prevent its complications [2].

Correlation of Diabetic Symptoms with Severity of Diabetes Mellitus in Middle-Aged Population

Purpose: To investigate the correlation of symptoms of Diabetes with the severity of Diabetes Mellitus (DM) in Middle-aged subjects with diabetes. Participants: 68 subjects with diagnosed diabetes mellitus between the ages of 40 and 60 with/without symptoms of neuropathy were included. Participants with neurological disease, recent surgical procedures or injuries to feet, vascular disease, and cognitive impairment were excluded. Method: In a cross-sectional observational study, a total of 68 middle-aged diabetic subjects were interviewed in terms of demographic data, Fasting Blood Sugar (FBS), Post-Prandial Blood Sugar (PPBS), HBA1c, duration of diabetes, and associated medical conditions. All participants were examined by the Michigan Neuropathy Screening Instrument (MNSI). MNSI consists of 2 parts. 1) questionnaire 2) clinical examination. Analysis: Statistical analysis was done by SPSS 20 & Spearman correlation test was applied. Results: In mild diabetes, hba1c has a weak positive correlation (r=0.232) with MNSI-1 and a very weak positive (0.016) correlation with MNSI-2. In moderate diabetes, hba1c has significant(p=0.003) strong positive correlation (r=0.703) with MNSI-1 and significant (p=0.019) moderate positive correlation (r=0.0596) with MNSI-2. In severe diabetes, hba1c has significant (p=0.028) moderate positive correlation (r=0.532) with MNSI-1 and significant (p=0.034) moderate positive (0.515) correlation with MNSI-2 Conclusion: Diabetic symptoms are moderately correlated with moderate & severe levels of Diabetes based on hba1c in the middle-aged population. Keywords: Diabetes Mellitus, Middle age, Diabetic symptoms, Michigan Neuropathy Screening Instrument.

Prevalence of Diabetic Macular Edema Using Optical Coherence Tomography in Type 2 Diabetics With Nephropathy in Comparison With Type 2 Diabetics Without Nephropathy.

The primary vision-threatening complication in patients with diabetic retinopathy (DR) is diabetic macular edema (DME). Diabetic nephropathy (DN) often has DR that threatens their vision and has a risk of developing DME. Hence, the presence of DN could be the only risk factor for developing DME without the presence of other factors. Hence, this study proposes to predict the prevalence of DME using optical coherence tomography (OCT) in type 2 diabetics with nephropathy in comparison with diabetics without nephropathy. This is a cross-sectional study done on patients visiting the Ophthalmology Department at Saveetha Medical College and Hospital, Chennai, for one year. A total of 120 patients were included in the study, with 60 diabetic patients without nephropathy in Group 1 and 60 diabetic patients with nephropathy in Group 2. A detailed history was recorded. Their recent blood reports of fasting blood sugar, postprandial blood sugar, hemoglobin A1c (HbA1c), renal function test, and urine protein/creatinine ratio were all noted. Chronic kidney disease (CKD) staging in nephropathy patients as done by the nephrologist was also documented. The best corrected visual acuity (BCVA) was assessed for distant and near vision. A slit lamp examination and dilated fundus examination were done. Fundus findings were independently graded according to the Early Treatment Diabetic Retinopathy Study (ETDRS) classification. OCT was done in all patients to confirm DME. In our study. males and females were 60 each in number. The majority of patients(32.5%) were >70 years old. A small percentage of patients (1.7%) in Group 1 had DM of >10 years, and 41.7% of the patients in Group 2 had DM of >10 years. Meanwhile, 73.3% of the patients in Group 1 had an HbA1c level between 6% and 7.5%, and 83.3% of the patients in Group 2 had an HbA1c level >7.5%. The percentage of patients with DME in Group 1 was 1.7%, and that in Group 2 was 21.7%. The majority of patients who had BCVA of 6/6 were in Group 1. The majority of patients with DME (46.4%) had stage V nephropathy. The coexistence of nephropathy in diabetic patients increases the incidence of DME. With long-standing diabetes and uncontrolled blood sugar levels being risk factors for developing DN and subsequently DME, such patients are to be screened regularly and advised on adequate glycemic control for achieving good visual prognosis and limit retinopathy progression. Moreover, the severity of DN should be kept in mind by nephrologists, and patients are to be promptly referred to the ophthalmology department for complete evaluation.

The effect of glycemic levels on Doppler indices and pregnancy outcome in pregestational and gestational diabetic pregnant women

Background Gestational diabetes mellitus (GDM) is characterized as a condition where there is a varying degree of intolerance to glucose, which occurs or is initially identified throughout pregnancy. Aim To evaluate the impact of glycemic control on Doppler indices of uterine, umbilical, and middle cerebral arteries (MCA) in pregestational and GDM women and to correlate alterations in maternal levels of glucose, glycosylated hemoglobin (HbA1c) and Doppler indices related to pregnancy outcome. Patients and methods This prospective comparative cross-sectional work was performed on 84 diabetic patients aged from 20 to 43 years old, pregnant women with singleton living fetus, at booking, gestational age (GA) 24–28 weeks gestation. The participants categorized into two groups equal: group A: Pregestational diabetes and group B: GDM. Results There was an insignificant correlation between mean HbA1c % and BMI, GA, and doppler velocimetry mean results pulsatility index (PI) of uterine artery (UtA), PI of umbilical artery (UA) and PI of MCA. Pregestational diabetic pregnant women was a significantly positive association with UtA PI. There was insignificant association with Age, UA PI, Middle cerebral artery PI, fasting blood sugar, 2 h postprandial blood sugar, HbA1c (%). Gestational Diabetic pregnant women had insignificant associations with age, UtA PI, UA PI, MSA PI, fasting blood sugar, 2 h postprandial blood sugar, HbA1c. Ultrasound findings, amniotic fluid index, weight, PI of UtA, PI of UA. Conclusion Pregestational and GDM were not correlated with irregularities in Doppler indices of uterine, umbilical, and MCA.

Real-World Effectiveness of Oral Semaglutide in Indian Adult Diabetic Patients: Evaluation of EMR-based Data

Abstract Introduction: Diabetes is increasingly becoming a significant health concern globally, including in India, where its prevalence continues to increase. Being overweight often acts as a catalyst for developing diabetes, exacerbating the condition and increasing the risk of other serious health complications such as heart disease, kidney problems, and nerve damage. Peptide-based molecules like semaglutide have proved their efficacy in controlling glycated hemoglobin (HbA1c) levels and body weight in diabetic patients. Objective: The present study aims to determine the effectiveness of oral semaglutide in a real-world setting. Materials and Methods: This retrospective study included patients ≥18 years of age prescribed oral semaglutide with a follow-up visit between 80 and 160 days post-prescription and had baseline body mass index (BMI) ≥ 30 kg/m2 and HbA1c levels ≤10.0%. The primary endpoints were to assess changes in HbA1c level, BMI, and body weight from the baseline. The secondary endpoints were to determine the changes in postprandial blood sugar (PPBS), fasting blood sugar (FBS), and blood pressure. The analysis also encompassed data on comorbid conditions and concomitant medications prescribed. Results: A total of 188 patients met the study eligibility criteria. At the follow-up visit, a statistically significant mean reduction of 0.34% in HbA1c levels and a weight loss of 1.83 kg were observed. The average duration between baseline and follow-up visit was 114.14 ± 21.5 days. The mean reduction in the BMI was 0.73 kg/m2 (P < 0.001). During the follow-up visit, the PPBS level decreased by 9.95 mg/dL and the FBS level decreased by 5.02 mg/dL. Additionally, the effect of semaglutide on blood pressure was evident, with a reduction in systolic blood pressure by 1.69 mm Hg and diastolic blood pressure by 1.30 mm Hg. The most common comorbid condition was dyslipidemia (66.49%), followed by hypertension (51.60%) and obesity (39.36%). Conclusion: Semaglutide demonstrated significant reductions in glycemic parameters, body weight, and blood pressure.

Exploring disparities: A comparative analysis of insulin-naïve, regular users, and inertia patients among type 2 diabetes mellitus outpatients in India

ABSTRACT Introduction: Insulin utilization pattern varies greatly in type 2 diabetes mellitus (T2DM) patients. Clinical inertia in treatment intensification hinders glycemic control in T2DM management. This study investigated insulin prescription trends and various predictors among insulin naive, user, and insulin inertia (II) patients in T2DM. Methodology: A retrospective analysis of T2DM patient records from the diabetes clinic at a tertiary care center was conducted. Data on socio-demographics, anthropometry, disease characteristics, comorbidities, adherence, and medication prescribing patterns were collected. Analysis was done using tests of significance, odds ratio (OR), and multivariate logistic regression. Results: A total of 950 records were analyzed, with 17.3% of patients identified as insulin users (IU), 70.9% being insulin-naïve (IN), and 11.8% having II. IUs had significantly higher glycemic levels including HbA1c, fasting, postprandial, and random blood sugars compared to the other groups. Higher HbA1c levels were associated with significantly increased odds of insulin usage (OR: 3.46, confidence interval (CI): 1.94–6.16), while individuals taking sulfonylureas had lower odds of insulin usage (OR: 0.27, CI: 0.08–0.91). A significant association was also seen with the total number of oral antidiabetic drugs prescribed (four drugs; OR: 15.6, and five drugs; OR: 9.1). Other factors did not show a significant association. The regression model showed HbA1c level as low as 7.9% could indicate a future insulin requirement in 22% of patients. Conclusion: The study outlines differences in characteristics and parameters among T2DM patients who require or do not require insulin and highlights the challenges in insulin initiation in Indian T2DM patients. Findings on II underscore the need for timely treatment intensification.

Correlation of Serum Electrolyte Imbalances With Diabetic Duration and Medication Use: A Cross-Sectional Comparative Study.

Certain anti-diabetic medications may exacerbate electrolyte imbalances, potentially complicating glycemic control in diabetic patients. The present study aimed to correlate the serum electrolyte imbalances such as Na+, K+, Ca+2, Cl-, and Mg+2 with the duration of disease, glycemic control, and medication regimens. In this cross-sectional study, 31 patients with type 2 diabetes mellitus (T2DM) and 30 healthy controls, with mean ages of 52.06 and 48.5 years, respectively, were recruited based on eligibility criteria. Data on demographic information, medication history, and duration of diabetes were collected. Fasting blood sugar (FBS), postprandial blood sugar (PPBS), glycated hemoglobin (HbA1C), and serum electrolytes were measured. The data were statistically analyzed. The mean differences in serum electrolytes between T2DM patients and non-diabetic participants were compared using the Mann-Whitney U test, and correlation analysis was performed. A p-value of <0.05 was considered statistically significant. Around 9.6% of participants had diabetes duration of less than one year, while the majority (45%) fell within the 1-5-year duration range. Most diabetic patients (61.2%) exhibited poor glycemic control. Statistically significant differences were observed between the mean FBS, PPBS, and HbA1C levels of T2DM (150, 249, and 8.82, respectively) and control group (95, 114, and 5.52, respectively). Analysis of serum electrolytes showedstatistically significant differences with regard toNa+, K+, andCl-between the diabetic and control groups. Mean sodium and chloride levels were lower and potassium levels were higher in diabetic patients compared to the control group. Negative correlations were observed between sodium and chloride levels and duration of diabetes and HbA1C levels. The study reveals significant electrolyte imbalances in patients with T2DM, characterized by reduced sodium and chloride levels and elevated potassium levels compared to healthy controls. These alterations are closely associated with poor glycemic control and longer disease duration, emphasizing the importance of regular electrolyte monitoring in T2DM management to mitigate potential complications.

Causality analysis of myopathy secondary to dapagliflozin therapy in type II Diabetes – A case study

Diabetes mellitus is a chronic metabolic condition that is becoming more prevalent globally. Diabetic patients must maintain adequate glycemic control in order to avoid or postpone diabetic complications. Diabetes care has evolved since the introduction of sodium-glucose co-transporter 2 inhibitors (SGLT2i). Postmarketing surveillance has shown cases of diabetic ketoacidosis and increased bone fracture risk associated with the use of SGLT2 inhibitors. We present a case of a 55-year-old female with a 6-year history of diabetes who exhibited weakness, muscular pains, and a burning feeling in her left thigh as a result of Dapagliflozin. Before initiating dapagliflozin treatment, the patient's fasting blood sugar (FBS) was 314 mg/dl and postprandial blood sugar (PPBS) was 343 mg/dl. After adding dapagliflozin as part of the therapy, the FBS improved to 179.24 mg/dl, and the PPBS decreased to 214.39 mg/dl, indicating a significant reduction in blood glucose levels. The introduction of Dapagliflozin in the treatment reduces the therapeutic gap compared to earlier treatment schedule, but retain the same side effect and became rechallenge. The instance of myopathy linked to dapagliflozin was confirmed following the causality evaluation by WHO Schales. It exemplifies the need for detecting drug-induced myopathy. Recently, minimal evidence has emerged showing a link between prolonged SGLT2 inhibitor use and accelerated myopathy. Myopathy is the generalised loss of skeletal muscle mass and function that occurs with ageing. Its existence is linked to negative health outcomes such as physical impairment, low quality of life, and death. Clinically, no other cause of myopathy was detected, and biochemical analysis indicated that dapagliflozin was the cause of her myopathy.

Effect of Vitamin D Supplementation on Glycemic Control in Newly Diagnosed Patients With Type 2 Diabetes Mellitus: A Randomized Controlled Trial.

Vitamin D deficiency is commonly associated with type 2 diabetes and it has been linked to impaired glycemic control in these patients. This study was done to determine if vitamin D supplementation improves glycemic parameters in type 2 diabetes. This randomized controlled trial was done in 140 newly diagnosed adult patients with type 2 diabetes. The participants were randomly divided into two groups where one group received vitamin D (60,000 International Units (IU) of oral vitamin D3 weekly for a duration of three months, followed by 1000 IU twice daily for another three months in vitamin D deficient patients; 1000 IU (25 mcg) twice daily for six months for subjects with sufficient vitamin D level) along with standard anti-diabetic drugs while the other group received standard anti-diabetic drugs only. The effect of vitamin D supplementation was assessed by measuring glycated haemoglobin (HbA1c), fasting blood sugar (FBS), postprandial blood sugar (PPBS), fasting insulin, and insulin resistance as Homeostasis Model Assessment of Insulin Resistance (HOMA-IR) at the baseline and after six months. Vitamin D deficiency was observed in 60% (n=84) of the subjects with the rest 40% (n=56) having sufficient serum vitamin D levels. The baseline mean HbA1c was 8.48 ± 1.46% and 8.21 ± 1.24% in the control and vitamin D group, respectively. After supplementing vitamin D for six months, no significant difference was observed between the two groups in terms of HbA1c (p= 0.263). Similarly, there was no significant change in other parameters like FBS, PPBS, fasting insulin, and insulin resistance (HOMA-IR). A subgroup analysis within the vitamin D group between the vitamin D sufficient and deficient patients also revealed no significant changes in the above parameters. Vitamin D supplementation, within the parameters of this study, did not yield a distinctive advantage in improving glycemic outcomes in individuals with type 2 diabetes.

Evaluating Blood Pressure Variability in Type 2 Diabetic Patients: An Insight into Non-Dipping Patterns and Their Clinical Implications.

Hypertension (HTN) is prevalent in individuals with type 2 Diabetes Mellitus (T2DM), doubling the risk of developing chronic complications. Despite normal routine checks, many patients with diabetes exhibit abnormal blood pressure (BP) profiles identified by 24-hour ambulatory Blood Pressure monitoring (ABPM). This study aimed to analyse blood pressure variability in patients with diabetes to enhance current knowledge and improve clinical practice. This cross-sectional study obtained ethical approval from Jazan University and involved 58 patients with type 2 Diabetes Mellitus (T2DM) who adhered to the strict inclusion and exclusion criteria. Comprehensive clinical and laboratory data, including demographic, clinical, and essential laboratory parameters, were collected using a standardized form. Blood Pressure (BP) was meticulously monitored using the Sun Tech Oscar 2 ABPMR device, with measurements commencing between 8 am and 10 am, extending over 24hours. The study calculated averages and evaluated systolic and diastolic percentage dipping during 24-hour, daytime, and night-time intervals. Participants classified as "dippers" experienced a BP reductions of at least 10%. Fifty-eight normotensive T2DM patients, with a mean age of 45.51 ± 6.7 years, were monitored over 24 months. Among the 58 individuals assessed using ABPM, a non-dipping pattern was observed in 45 participants (77.58%), whereas 13 (22.41%) exhibited a dipping pattern. Postprandial and fasting blood sugar levels were distinct; the dipper group demonstrated better post-meal glucose control (p=0.02), whereas the non-dipper group had superior fasting glucose control (p=0.04). The dipper group showed a higher 24-hour average systolic BP (p=0.00) and increased dipping percentages for systolic and diastolic BP during sleep. Over 77% of ABPM-evaluated individuals showed non-dipping patterns, with a higher BMI being strongly associated. Laboratory findings revealed distinct variations in the postprandial and fasting blood sugar levels, suggesting a potential genetic predisposition.

Assessment of glycemic control and correlation of HbA1c level with lipid profile and duration of diabetes in type 2 diabetes mellitus patients

Background &amp; Objectives: The prevalence of Type 2 diabetes mellitus, or Type 2 DM, is rising globally. A periodic estimation of HbA1c has been recommended to track the state of glycemic control of Type 2 DM patients, in order to control the diabetes associated disorders. The main consequence and cause of death in Type 2 diabetes has been identified as cardiovascular disease (CVD).Optimization of glycemic status along with decreasing CVD risk factors are critical to preventing morbidity and mortality in patients with Type 2 DM. Since there is a lack of data on these CVD risk factors, in Madhesh Province, Nepal, we aimed to evaluate the glycemic status, estimate the lipid profile, and ascertain their correlation, including duration of Type 2 DM among patients in tertiary care hospitals in Madhesh Province, Nepal. Materials and Methods: The tertiary care hospital based cross-sectional study was conducted on 139 Type 2 DM patients, in Madhesh Province, Nepal. In order to gather information of the participants, a systematic questionnaire was introduced. A physical and clinical examination was performed, and an appropriate volume of blood was drawn with prior written consent. The lipid profile parameters, HbA1C, Fasting and post prandial serum glucose were estimated. Results: In 84 (60.3%) and 106 (76.3%) cases, there was an increased fasting and postprandial blood sugar. The mean±SD HbA1c level was 8.40±0.8%. More than half (52.5%) of the patients had poor glycemic control, while 22.3% had inadequate glycemic control, in reference to HbA1c &gt;8% and 7 to 8%, respectively. A substantial increased level of LDL-C, triglycerides and total cholesterol was observed in 122 patients and 85.6% had reduced HDL-C. A significant strong positive association was found between HbA1c level and total cholesterol and triglycerides, in contrast, no discernible association with duration of disease observed. Conclusion: Glycemic control was inadequate. Triglycerides and total cholesterol were significantly positively correlated with HbA1c, but not with HDL-C, LDL-C, or the course of diabetes.

Exploring Factors Influencing Stroke Risk: Insights From a Predictive Analysis.

Introduction Stroke is a serious medical condition characterized by the sudden interruption of blood flow to the brain, resulting in the death of brain cells. It is a leading cause of long-term disability and mortality worldwide. Stroke has some associated risk factors, both modifiable and non-modifiable ones.As for non-modifiable risk factors, these are age, gender (men are more vulnerable), and family history of stroke.The controllable or adjustable risk factors include hypertension (high blood pressure), diabetes, smoking, high cholesterol levels, obesity, and insulin resistance. Methods In our study, we collected data from 229 patients which were originally collected for clinical purposes and were retrospectively analyzed. These data contain features such assex and age, the presence of ischemic heart disease (IHD) or stroke history, and different blood sugar readings. These measurements include fasting blood sugar (FBS), postprandial blood sugar (PPBS), HbA1c%, and insulin levels (fasting and postprandial).Furthermore, cholesterol was also tested, such as total cholesterol, triglycerides (TGL), high-density lipoprotein (HDL), low-density lipoprotein (LDL), and very low-density lipoprotein (VLDL). Surprisingly, stroke was observed in 24of the 205 patients. This contrast permits us to be concerned with the chance of the association between stroke and insulin levels. Given the imbalanced nature of our outcome variable (stroke occurrence), the primary analytical method will be logistic regression. Results In this cross-sectional study, we investigated the association between high insulin levels (both fasting and postprandial) and the occurrence of stroke within a dataset of 229 patients. Out of the 229 included cases, 102 individuals were female (44.5%) and 127 individuals were male (55.5%). Twenty-four cases have ischemic heart disease (10.5%). Among the analyzed cases, 24 individuals have a history of stroke. The average age of the sample is approximately 57 years ± 14.87. There was no significant difference between the males and females in most of the descriptive statistics. However, females experienced significantly higher levels of postprandial glucose level and significantly lower levels of postprandial insulin. According to our predictive model, we found that an increase in fasting insulin levels was linked to a lower risk of stroke occurrence. On the other hand, increasing insulin postprandial levels and age were associated with an increased risk of stroke. Conclusion Our study identified age, fasting insulin, and postprandial insulin as key factors influencing stroke risk. Higher fasting insulin levels were associated with reduced risk, while increased postprandial insulin and age were linked to higher risk. Blood glucose, cholesterol, and triglycerides had minor effects. Notably, higher total cholesterol and triglyceride levels were slightly associated with lower stroke occurrence. Further research with larger samples is needed for validation.

Serum NT-proBNP levels in diabetes and its association with obesity, inflammation and glycemic status

Background: Type 2 diabetes mellitus (T2DM) patients are more prone to develop cardiovascular complications, and there is a dire need of a routine screening tool for risk assessment of heart failure (HF) in them. Aims and Objectives: The current study was conducted to estimate the levels of serum N-terminal pro-B-type natriuretic peptide (NT-proBNP) concentrations in subjects with and without T2DM and evaluate the association between NT-proBNP and body mass index (BMI), waist circumference as markers of obesity, hemoglobin A1c (HbA1c), plasma fasting blood sugar (FBS), plasma postprandial blood sugar (PPBS),duration of diabetes as markers of glycemic control and serum C-reactive protein (CRP),an inflammatory marker in diabetic subjects. Materials and Methods: A hospital-based cross-sectional non-interventional study was done with 82 non-diabetic healthy volunteers and 82 T2DM patients. Anthropometric measurements (waist circumference [WC] and body mass index [BMI]) were recorded, and blood was analyzed for serum NT-proBNP, C-reactive protein (CRP), plasma fasting blood sugar (FBS), postprandial blood sugar (PPBS), and hemoglobin A1c (HBA1c). Data collected were analyzed by statistical software with P&lt;0.05 as the significance level. Results: Serum NT-proBNP level was significantly higher in diabetic group (P&lt;0.001) compared to non-diabetic group statistically. Correlation analysis in diabetic subjects showed a significant positive correlation of NT-proBNP with CRP (ρ+0.576, P&lt;0.001), duration of diabetes (ρ+0.780, P&lt;0.001), plasma FBS (ρ+0.524, P=0.003), plasma PPBS (ρ+0.673, P=0.013), and HbA1c (ρ+0.571, P=0.001) but there was no statistically significant correlation of NT-proBNP with BMI or WC values although the correlation was negative for both. Conclusion: The present study provides a novel perspective that measuring serum NT-proBNP may help in the earlier identification of impending HF in diabetic individuals assisting in prompt intervention which may be further confirmed by larger studies.

Association Between the Triglyceride-Glucose Index and Serum Uric Acid to High-Density Lipoprotein (HDL) Cholesterol Ratio in Type 2 Diabetes Mellitus in Gabes City, Tunisia.

Background Type 2 diabetes mellitus (T2DM) is a significant risk factor for cardiovascular diseases (CVD). The triglyceride-glucoseindex (TyGi) is a novel biomarker for insulin resistance, strongly linked to CVD. Elevated serum uric acid levels and the uric acid to high-density lipoproteincholesterol ratio (UHR) are emerging as markers of metabolic syndrome and cardiovascular risk in T2DM. This study aimed to explore the association between the TyGiand UHR in T2DM patients. Objectives The aim of this study is to compare metabolic parameters in T2DM patients and assess the association between the TyGiand serum UHR. Methodology A cross-sectional case-control study was conducted at the University Hospital of Gabes, Gabes City, Tunisia with 50 T2DM patients and 50 gender-matched healthy controls. Inclusion criteria included adults aged 30-75 years with a confirmed diagnosis of T2DM on stable medication for at least three months. Exclusion criteria included other types of diabetes, significant liver or kidney disease, recent cardiovascular events, endocrine disorders, and substance abuse. Metabolic and biochemical parameters, including fasting blood sugar, postprandial blood sugar, glycosylated hemoglobin, lipid profile, and renal function, were measured. The TyGiand serum UHR were calculated and analyzed for correlations. Results T2DM patients exhibited significantly higher fasting blood sugar, postprandial blood sugar, glycosylated hemoglobin, TyGi, and serum UHR compared to controls, indicating impaired glycemic control and adverse lipid profiles. The UHR showed a positive correlation with a strong negative correlation with HDL and a positive correlation with uric acid levels. The linear regression analysis indicated a weak positive trend between the TyGi and serum UHR, although not statistically significant. Conclusion This study underscores the importance of the TyGiand serum UHRas biomarkers for evaluating metabolic and cardiovascular risk in T2DM. Further research is needed to explore their combined utility in clinical practice for early detection and management of cardiovascular complications in diabetic patients.

Correlation of glycosylated hemoglobin (HbA1c) with retinal nerve fiber layer (RNFL) thickness and central macular thickness (CMT) in the diabetic population in North India.

The current study was aimed to find correlation of glycosylated hemoglobin with retinal nerve fiber layer thickness (RNFLT) and central macular thickness (CMT) in the diabetic population in North India. This was a cross-sectional observational study of 300 diabetic patients divided equally in two groups with and without retinopathy, and 150 people were included as control. The study was conducted from October 2020 to August 2022. All patients underwent slitlamp fundoscopy with a +78 D lens, and spectral-domain (SD) optical coherence tomography was performed to measure the RNFLT and CMT, and the staging of retinopathy was done as per the ETDRS classification. Along with that, blood investigations were ordered, including fasting (FBS) and post-prandial (PPBS) blood sugar and glycosylated hemoglobin (HbA1c). Quantitative variables were compared using one-way analysis of variance, or Kruskal-Wallis test was applied for inter-group comparison, followed by a Student Newman Keuls Test. The mean age of the patients in the diabetic group with retinopathy was 52.62 ± 9.38 years. The overall male: female ratio was 3:2. The mean FBS in the diabetic group with retinopathy was 146.54 ± 45.40mg/dl; the PPBS and HbA1c in the same were 210.39 ± 63.71mg/dl and 7.85 ± 1.33%, respectively. RNFL thinning was found in all four quadrants in diabetics irrespective of the status of retinopathy (P-value = 0.000) with a significant weak negative (r<0.4) correlation of glycosylated hemoglobin values with RNFLT in the inferior (r value = -0.300, P-value = 0.000) and superior (r value = -0.236, P-value = 0.004) quadrants of right eyes and in inferior (r value = -0.176, p- value = 0.031), superior (r value = -0.222, P value = 0.006), and nasal quadrants (r value = -0.166, p- value = 0.043) of left eyes in diabetics with retinopathy. However, in diabetics without retinopathy, no correlation was found. On correlating HbA1c with CMT, a weak positive (r<0.3) association existed in both eyes in the diabetic group without retinopathy (r = 0.020 and 0.048 for OD and OS, respectively) and diabetics with retinopathy (r = 0.152 and 0.127 for OD and OS, respectively). However, the association was not found to be significant in either of the groups (P-value > 0.05). The study concluded that neurodegeneration occurs in diabetic retinopathy as evident with nerve fiber layer thinning, and it is negatively correlated with glycosylated hemoglobin (HbA1c).